Permit n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1,1
• • COMMUNITY DEVELOPMENT Permit#: FPS2015-00123
Date Issued: 08/06/2015
TEGA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S1266C01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 550
Project: LoanStar Lending Subdivision: 2005-035 PARTITION PLAT Lot: 3
Project Description: Fire sprinkler-Relocate(3)heads for TI
Contractor: FIRE ONE FIRE SYSTEMS INC Owner: WISCO REAL ESTATE EQUITY FUND I
PO BOX 734 1501 SW TAYLOR ST STE 100
OREGON CITY, OR 97045 PORTLAND, OR 97205
PHONE: 503-557-9050 PHONE:
FAX: 503-557-9268
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/06/2015 $53.78
12%State Surcharge-Building 08/06/2015 $6.45
Type of Use: COM Plan Review-Fire Life Safety-COM 08/06/2015 $21.51
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 08/06/2015 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $82.24
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $550.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance - • suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Ore.on
Utili otification Center. Tho les are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may j> ain . copy of the a -.
or:irect questions to OUNC b ailing 03.232.1987 or 1.800.332.2344.
i
Issued By: J 4 Permittee Signature: '�
Call 503.639.4175 by 7:00 a.m.for the next available inspect'. date.
— This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
City of Tigard ECEIVE permit No.: �S -G���3
�/s
13125 SW Hall Blvd.,Tigard,OR 97223 / /
Phone: 503.718.2439 Fax: 503.598�I r�i 6 2015 Date Received: • a
i i,; ,i,i, Inspection Line: 503.639.4175
Internet: www.tigard-or.gov By: 1 __' d, •
CITY OFTIGARD
FIRE SPitillkIM,(Eii A IMDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name:L.S.9A S AcZ kibMt.(--0,1 I)I$164 Occupancy:
Job Address:CtO ?r) SkJ.) 01,1v-11.\41.-0 0 a0Aarype of Construction:
Suite: 55°
Contractor: i-- i,ke Op e F(QZ�,SCf s-T` c PhonGv31 551 —9 Co$ 0
Number of Proposed or Altered Heads: 3
Type: Hazard: L---,‘ 4,.f- r Density: 0 5
I, NI 1 CAL. B 00 CA"( L'ill Oregon Construction Contractors Board No. 8 (( Q
certify the following is true and reasonably defines the scope of work for this project:
a) All work is limited to drops and armovers in a light-hazard occupancy.
b) Positions of sprinkler heads relative to architectural features such as soffits, beams, partitions, walls, etc.
complies with current adopted edition of NFPA 13.
c) The proposed work does not require hydraulic calculations.
d) Only one sprinkler head will be installed from one drop (exception: up to two heads from one drop may be
installed when each head is in a separate fire area).
e) The area covered per sprinkler head is limited to the spacing requirements of NFPA 13.
f) Tenant improvements in a new building shall be equipped with Quick Response heads(see 2002 NFPA 13,
Section 8.3.3.1 for exceptions).
g) The installation shall comply with the requirements of the current adopted edition of NPFA 13.
h) Piping shall not be concealed until hangers and bracing are inspected.
i) Final approval shall be subject to onsite tests and inspections.
In addition, I understand the following is required:
• Submit(3) copies of a sketch showing the area of work within the building's structure.
• Building fire protection system permit.
• A copy of this document with a copy o he sketch attached shall be available for all inspections.
/ C
Signature:�� 1 -A Date: V '-s -I
5'
Print Name:'
I■1 I CAA .3 0 Ca (eTT /
L\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1
Building Permit Applicata RtiECEIVEP
Fire Protection System FOR OFFICE USE ONLY
City of Tigard AUG 6 2015 RDattee/s�y: '/4'�5 (' _ N/ Ji`G15 -C x'/?- ,
Permit No.: /`
i" 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.59&t11°OF T IG ARD Other Permit: -1/,,ai
!„1 L Date/By: c/��l /
TIGARD Inspection Line: 503.639.4175 ` is (� 1 Date Ready/By: Jana See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of al
CgAddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the prr for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling kt_ m
Comercial/industrial Valuation: $
El Accessory building El Multi-family Number of bedrooms:
❑Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9(f0 50, k.1 f j -/—Q New dwelling are.• square feet
City/State/ZIP: `,f !r 112_0 p`L b-1"�'Z Garage/carp, area: square feet
Suite/bldg./apt.no.:550 Project namej p
'-.1— it-t-'(:tLLt .4p /lam Cover-: porch area square feet
Cross street/directions to job site: Sal-k 00-1._ •V"--'efAZ_P-S.--/ area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicate¢on this application.
�U C�-i- e c5 5 P,.I io Valuation:�' Q +
-1t; bs '���\� u E yt L-L� Existing building area square feet
1 /� New building area: square feet
❑ PROPERTY OWNER p■KENANT Number of stories:
Name: $ — 4 ll • tibt'1 G L-1,-CN Dc YLI G- Type of construction:
Address: 9)(2.2._z) S L� W4S -{(h.16. tMtj /� j Occupancy groups:
City/State/ZIP: C QD1 Existing:
Phone:( ) Fax:( ) New:
( PPLICANT ,CONTACT PERSON NOTICE —
Business name: t_. ikiLt. ,u. �I r L E '1 1 ( 1.S' All contractors and subcontractors are required to be
Contact name: t Gy_ - L—"T V A licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: v b L 0 D-/` 473 LI-- jurisdiction in which work is being performed.If the
�, t applicant is exempt from licensing,the following reasons
City/State/ZIP: t'�1 QQ-e ��d 4_5
q apply: _
Phone:(5a3,5751 �Ch� d I Fax::( r Sig--/`�Zfo r7
E-mail: ( .T-2..,(I)__ . t . OPseer-
CONTRACTOR BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
Address: 65wc-
p e,o v Permit fee:City/State/ZIP: /� State surcharge(12%of permit fee):
FLS plan review(40%ofpermit fee):
Phone:( ) I Fax:( ) (Due upon application.)
CCB lie.: r +I LI, 0 e/%49/7 7 , Total permit fees: [�
/� Amount received: Ova °�/
Authorized signature: / /6 ■
` ii This permit application expires if a permit is not obtained
Print name: N yso csc {e-rmi-/ Date:, within 180 days after it has been accepted as complete.
if * Fee methodology set by Tri-County Building Industry
Service Board
1:\Building\Permits\FPS-PermitApp.doc 02/01/2011 440-46131(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Mann
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal(see A,B&C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12%of permit fee): $
FLS Plan Review(40%of permit fee): $
TOTAL: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
I:\Building\Permits\FPS-PermitApp.doc 02/01/2011 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9020 SW WASHINGTON SQUARE RD 550,
TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2015-00123
Jeff Grove
Violation Summary:
Inspector Contractor